UK: Electronic Reporting For GPs?

The NHS is being pulled in two different directions. On the one hand it is facing increasing pressure to become more “digitised” and to get in line with modern standards. The National Director for Patients and Information at NHS, Tim Kelsey, said the NHS is not doing enough to become a digital organisation with only 2% of people having "engaged digitally with the NHS" despite 76% of the UK population routinely using the internet.

On the other hand, in order to make a more prominent move in the digital space, the NHS faces one very sensitive issue: patient record confidentiality. Just earlier this year, it was reported that hospital records of 47 million NHS patients were obtained by insurers. This caused a major uproar and it came on the heels of controversial NHS plans to share patient information in a central database.

Niche Health, a company that provides safe and secure records management solutions for Primary Care, has developed a solution to protect patient confidentiality. I am speaking with Guy Bridgewater, Managing Director of Niche Health, on the phone about Intelligent GP Reporting (iGPR), his company’s product that only allows authorised data to be provided to third parties.

“It’s an end-to-end solution that would allow a third party to send the request to the GP. The GP would then electronically create the report and the software will automatically remove any inappropriate and non-permitted data from the report before then securely passing that back to the requesting third party. All of that is done from the back of the explicit consent from the patient,” Bridgewater says.

Bridgewater has worked within healthcare IT for 25 years. The inspiration for Niche Health came when he noticed that there were a number of processes that exist within the primary care sector that are still very paper-heavy, cumbersome and time-consuming for GPs and their practice staff.

“I felt that the technology and technical solutions to those processes could massively reduce the times they are spending on fulfilling the requirements of others by producing a product. That’s really how we started,” Bridgewater tells me.

Bridgewater started looking at the process that GPs go through for dealing with report requests from third parties. This included: insurers, solicitors, and other organisations requesting medical reports from GPs and the time spent during the process. This influenced the idea for the iGPR product.

I am keen to understand how the filtering system works. How does the system judge which information to take out?

“Fundamentally there is an agreement between the BMA and the ABI that dictates what should not be sent in the request,” Bridgewater says.

Bridgewater gives the example of an application for life protection insurance. Information that would be stripped out would include: HIV negative tests, predictive genetic testing, and reference to third parties that exists within the patient record.

What were the technical challenges in developing the product?

“In terms of creating the report, the first challenge was to do that quickly. At the moment, from the pilot it takes on average an hour and 15 minutes to create a report for a third party. One of our technical challenges was that if we were going to do it electronically we need to do it substantially more quickly,” Bridgewater says.

Bridgewater tells me Niche Health has achieved the goal of getting the process down to under ten minutes now and says GPs have full control over the system.

Who has iGPR been adopted by so far?

“In terms of third parties it’s been adopted by Legal & General, the largest provider of life protection in the country. We are in discussions with pretty much all the other insurance providers in the UK in different stages.”

In 2013, Health Secretary Jeremy Hunt set the NHS a challenge to become paperless by 2018. The aim is to give people online access to their health records by March 2015 and by April 2018, any crucial health information should be available to staff at the touch of a button.

I ask Bridgewater if a paperless NHS achievable by 2018.

“It depends on how you define paperless really to be quite honest with you. There are certainly a number of areas where we will achieve a paperless NHS by that time but I think paperless is a really broad term – there are a whole host of technologies and processes that you could brush stroke with the term paperless,” Bridgewater says.

“I think in terms of the outline of what they are trying to achieve for paperless - yes that is achievable. But I think there are other things that fall outside of that which will probably take some more time. But ultimately we will get there,” Bridgewater adds.

Towards the end of our call I am interested in learning Bridgewater’s opinion on whether the NHS is doing enough to become a digital organisation? Is it far behind the healthcare system in the US?

Bridgewater is adamant that the NHS is not far behind.

“In terms of technology in healthcare the UK is by far and away a huge leader and I don’t see us as lagging behind. The US is very fragmented because of the vast array of systems that exist for capturing information points of care. I absolutely see the UK as trailblazing toward what we are achieving at the moment.”